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Bryostatin 1 Plus Vincristine in Treating Patients With Recurrent or Refractory HIV-Related Lymphoma
This study has been completed.
Study NCT00022555   Information provided by National Cancer Institute (NCI)
First Received: August 10, 2001   Last Updated: August 23, 2008   History of Changes
This Tabular View shows the required WHO registration data elements as marked by

August 10, 2001
August 23, 2008
August 2001
 
 
Complete list of historical versions of study NCT00022555 on ClinicalTrials.gov Archive Site
 
 
 
Bryostatin 1 Plus Vincristine in Treating Patients With Recurrent or Refractory HIV-Related Lymphoma
A Phase I Trial of Combination Bryostatin-1 and Vincristine in HIV-Related B-Cell Neoplasms

RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Bryostatin 1 may help vincristine kill more cancer cells by making them more sensitive to the drug.

PURPOSE: Phase I trial to study the effectiveness of bryostatin 1 plus vincristine in treating patients who have recurrent or refractory lymphoma.

OBJECTIVES:

  • Determine the maximum tolerated dose of bryostatin 1 when administered with vincristine in patients with recurrent or refractory HIV-related B-cell lymphoma.
  • Determine the toxicity profile of this regimen in these patients.
  • Determine the objective response and survival of these patients treated with this regimen.
  • Determine the immunomodulatory effects of this regimen on interleukin-2 (IL-2), IL-2 receptor, and IL-6 cytokine levels in these patients.
  • Determine the effect of this regimen on CD4+ lymphocyte count and HIV load in these patients.
  • Determine the effect of this regimen on the human herpes virus-8 load in these patients with body cavity-based lymphoma.

OUTLINE: This is a multicenter, dose-escalation study of bryostatin 1.

Patients receive bryostatin 1 IV continuously on days 1 and 15 and vincristine IV over 5 minutes on days 2 and 16. Treatment continues every 4 weeks for a minimum of 2 courses in the absence of disease progression or unacceptable toxicity.

Cohorts of 3-6 patients receive escalating doses of bryostatin 1 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 6 patients experience dose-limiting toxicity.

PROJECTED ACCRUAL: A total of 9-12 patients will be accrued for this study.

Phase I
Interventional
Treatment
Lymphoma
  • Drug: bryostatin 1
  • Drug: vincristine sulfate
 
 

*   Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.
 
Completed
 
 
 

DISEASE CHARACTERISTICS:

  • Histologically confirmed B-cell lymphoma

    • Eligible subtypes:

      • Intermediate or high-grade non-Hodgkin's lymphoma (NHL), defined as follicular large cell, mantle cell, diffuse mixed cell, diffuse large cell and variants, Burkitt or Burkitt-like, or unclassifiable aggressive histologies
      • Body cavity-based lymphoma or primary effusion lymphoma
  • Evidence of HIV infection
  • Received at least 1 prior systemic chemotherapy regimen with failure to respond or relapse after completion of first-line therapy, including one of the following doxorubicin-based combinations:

    • Cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)
    • Infusional cyclophosphamide, doxorubicin, and etoposide (CDE)
    • Etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (EPOCH)
  • Evaluable disease outside of prior radiation port
  • No CNS parenchymal or leptomeningeal involvement
  • No primary CNS NHL
  • No HTLV-1-associated leukemia or lymphoma NOTE: A new classification scheme for adult non-Hodgkin's lymphoma has been adopted by PDQ. The terminology of "indolent" or "aggressive" lymphoma will replace the terminology of "low", "intermediate", or "high" grade lymphoma.

However,this protocol uses the former terminology.

PATIENT CHARACTERISTICS:

Age:

  • 18 and over

Performance status:

  • Karnofsky 70-100%

Life expectancy:

  • At least 12 weeks

Hematopoietic:

  • Absolute granulocyte count at least 1,000/mm3
  • Platelet count at least 75,000/mm3
  • Hemoglobin at least 8.0 g/dL

Hepatic:

  • Bilirubin no greater than 1.5 mg/dL (unless concurrently on indinavir)
  • SGOT and SGPT less than 3 times upper limit of normal

Renal:

  • Creatinine no greater than 1.5 mg/dL OR
  • Creatinine clearance at least 50 mL/min

Cardiovascular:

  • No history of cardiac disease
  • LVEF at least 45% by radionuclide ventriculography
  • No symptomatic congestive heart failure
  • No active angina pectoris
  • No uncontrolled hypertension

Pulmonary:

  • No history of symptomatic pulmonary disease
  • Corrected DLCO more than 50% predicted
  • No severe chronic obstructive lung disease
  • No symptomatic restrictive lung disease

Other:

  • Recurrent controllable infection (e.g., thrush) on chronic suppressive therapy allowed
  • No active uncontrolled infection
  • No active significant opportunistic infection (e.g., acute Pneumocystis pneumonia, cytomegalovirus retinitis on induction or maintenance therapy, acute toxoplasmosis)
  • No grade 2 or greater peripheral neuropathy
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective barrier contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy:

  • At least 24 hours since prior transfusion
  • At least 24 hours since prior colony-stimulating factor therapy
  • No concurrent prophylactic filgrastim (G-CSF)

Chemotherapy:

  • See Disease Characteristics
  • No concurrent hydroxyurea

Endocrine therapy:

  • Not specified

Radiotherapy:

  • See Disease Characteristics
  • At least 4 weeks since prior large-field radiotherapy

Surgery:

  • Not specified

Other:

  • At least 3 weeks since prior anticancer therapy and recovered
  • Must be receiving stable antiretroviral regimen of at least 4 weeks duration
Both
18 Years and older
No
 
United States
 
 
NCT00022555
 
AMC-029
AIDS Associated Malignancies Clinical Trials Consortium
National Cancer Institute (NCI)
Study Chair: Scot C. Remick, MD Case Comprehensive Cancer Center
National Cancer Institute (NCI)
September 2001

 †    Required WHO trial registration data element.
††   WHO trial registration data element that is required only if it exists.